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14040190 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10649 MAPLEWOOD RD CONTRACTOR:ABE CONSTRUCTION, PERMIT NO: 14040190 INC OWNER'S NAME: ESSEX THE POINTE LP 1233 MIDAS WAY DATE ISSUED:04/28/2014 OWNER'S PHONE: 6504943700 SUNNYVALE,CA 94085 PHONE NO:(408)734-8416 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL APT C-REMODEL BATHRROM(120 SQ FT); KITCHEN(160 License Classs ck# c10/ C 3A SQ FT); ADD NEW LAUNDRY ROOM,UPGRADE ELECTRICAL Contractor SSS�x Date 2g' PANEL AND PLUMBING. I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the erformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$24000 Jhave and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:31643003 10649 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter ED INSPECTION. upon the above mentioned property for inspection purposes. (We)agree to save 180 DA indemnify and keep harmless the City of Cupertino against liabilities,judgments, c' costs,and expenses which may accrue against said City in consequence of the ssue Date: �a granting of this permit. Additionally,the applicant understands and will com with all non-point source regulations per the Cupertino Municipal Code,Section 918. �/ RE-ROOFS: Signature Date / All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: permit is issued. I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9 18. Signature Date (� V CONSTRU CTaC Gni PERK N T APPU -4 QON O COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION �O 10300 TORRE AVENUE�CUPERTINO, CA 95014-3255 CSC ER�I, i (408)777-3228°FAX(408)777-3333� building(bcuperiino org �f[�/� �/�/'� ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# 7-��C7t7'�`� PROJECT RE S �APN4ala [ uloo 1�d C1316 -3 d o 3 . I o G OWNER NAME G I� .V f �1 v�� I P V/k~ -1 STREET ADDRES i-� ? �•C �� ru� C�� E- qA) Dv' ('� o�G�l�fl CA q 1303 I FAX CONTACT NAME 1 c m U t( PRONE 'J �S�-8 5-l"I d3 E-MAIL STREET ADDRESS CrIY, ATE,ZIP FAX ❑OWNER ❑ OWNER-BUH.DER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME A�y�y�I j^ +, ^ �� LIC Sk j 'IypE BUS.LIC# igNSE COMPANY NAME HT 1°j-,MK CNI(�{,�V�VrC 1�I" ��1.'"�r•' 1/vI] FAX 1. CO lube ►eft vCp& -inc- - (7t1-O q STREET ADDRESS 133 M ( �0 0 , )OL CITY,STATE,2SUr1Va-IES A a L jpg 5 PHO o � 73q-&1(0 6 ARCHITECT/ENGINEER NAME G V.IJ w LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK 1 hAt� r�c�eh . q het,Uklondv-V v m U IoIO)Q ICQ� and 01L)M&Y19 EXISTING USE PROP O1 USE CONSTR TYPE 7S-TORIES ry)o l 1 - USE TYPE OCC. gQ SQ.FT. VALUATION($) QAC* ��u NEW FLOOR I O DEMO TOTAL V f�S,J, AREA NETAREA - A PT �" ^ 2-q BATHROOM KITCHEN OTHER 7` a REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECKAREA TOTAL DECKIPORCH AREA GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: TS A SECOND UNIT YES SECOND STORY DYES BEINGADDED? ONO ADDITION? ONO PRE APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN PLANNING APPL# ❑NO PLANNING APPROVAL LEITER EICH FR HOME? D NosVALUATION: By my signature below,I certify to each of the following: I am the property owner or authorized ct on the property owner's behalf. I have read bis application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction uthorize representatives of Cupertino to enter the above-Iden' d prop for inspection purposes. Signature ofApplicantlAgent Date: SUPPLEME TION REQUIRED PLAN CHECK TYPE ROUTING SLIP New SFD or Multi f ellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building ❑ ° TzcowTER ❑ Burr-DING PLAN REVIEW permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FII2E DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. ❑ MAJOR ❑ SANIT'ARYSEWER DISTRICT ❑ EN MONMENT4LHEALTH BIdgApp_2011.doc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10649 Maplewood Rd#C DATE: 04/28/2014 REVIEWED BY: MELISSA APN: 31643003.10649 BP#: *VALUATION: $24,000 xPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY Buildina is 7PENTAMATION1 REAP2 USE: Multi-Family Dwelling >3 Stories 0 Yes (D NoRMIT TYPE: i WORK A t C - Remodel Bathrrom 120 sq ft); Kitchen 160 sq ft); Add new laundry Room upgrade electrical SCOPE panel and plumbing. Vec/t Plan 1'l'oid).Plart Check HPIan0.0 hrs $0.00Permit Fee: 1EPERMITt)rltE r Ptt tl 1rt;. hrs $47.00n NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These fees are based on the prelimina information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 11-053 E . 7ff 11113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 200 Jamps Electrical Suppl.PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $47.00 IBELEC200 Services PME Plan Check: $0.00 Permit Fee: Hourly Only? ®Yes (E)No $0.00 Suppl. Insp. Fee: Reg. Q=OT 0,0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $47.00 T7=1�{rzsttrtt�Zaua2 1 c:�: Administrative Fee: IADMIN $44.00 G Work Without Permit? 0 Yes (E) No $0.00 Advanced Planning Fee: $0.00 L�.J hours Inspections G Travel Documentation Fee: ITRA VDOC $47.00 $695.00 isTINSP Inspection,Hourly Strong Motion Fee: IBSEISMICR $2.40 Select an Administrative Item Bldp Stds Commission Fee: 1BCBSC $1.00 .� $141.40 $742.00 TOTAL FEE: $883.40 Revised: 04/01/2014 Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: GO a !, PERMIT# YOY OLS 0 OWNER'S NAME: s PHONE# — GENERAL CONTRACTOR: CCCX,7-10AI BUSINESS ICENSE# 3 3 ADDRESS: 12as -u/qy as—u/ Sah CITY/ZIPCODE: C,4 9 D *Our municipal code requires all businesses working in the city to have a City of Cupertino tusiness license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE-SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS :HAVE OBTAINED A`CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: 7 ig ature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date